Ross Procedure

[cday]

vtwhip,

It is a very difficult decision. I believe that whether you have Ross or Tissue you must consider the fact that you could be facing a re-op. At least one member has mentioned a re-op required with Ross in as little as 8 years. A few mechanicals have even required re-ops.

It's more of a "pick your poison" dilemma. There is a valve selection worksheet in the Valve Selection -- I don't this it considers Ross though -- It might give you some points to think through.

 

[chilihead]

Ross Procedure

Anything under 50 Ross procedures would be too low in my book. I'd either head to Cleveland or come on to Texas. We have Dr. William Ryan in Dallas and Dr. John D. Oswalt in Austin who both have over 200 Ross procedures with very good statistical results. You need a backup plan in case they get in there and determine that your not a good candidate for the procedure. If I were doing it today I'd choose Ross, then On-X as plan B.

Good luck. I know it sucks having to decide.

 

[chilihead]

Ross Article

Ross Article

http://www.cardiothoracicandvascularsurgeonstexas.com/images/stories/CTVS-Volume-Issue-1.pdf

 

[Turkey Hunter]

I will caution anyone looking at great outcomes because IT IS an INDIVIDUAL thing. One has no idea what the outcome will be until it is done.

I have to agree with Ross; you can never make a blanket statement about recovery being either easy or difficult.

Mine was fairly easy; one small bout of arrythmia's....other than that I was back to work in 3 1/2 weeks (part time) and back to full time at 6 weeks. In the gym lifting light weights and walking 4 miles a day at that point.
So I had the RP and did not recover near as fast as some; but substantially quicker than others.....recovery is what it is with each person.

Ben

 

[ALCapshaw2]

I suspect that the Most Experienced Ross Procedure Surgeon in the NE is Dr. Paul Stelzer, Beth Israel Med. Ctr., NYC. He is probably over 375 now which may make him the most prolific RP Surgeon in the country.

See the Member Profile for "StretchL" and go to the link for his RP PhotoAlbum. You may also want to read over his posts leading up to his RP surgery. VERY informative info.

'AL Capshaw'

 

[Leah]

I suspect that the Most Experienced Ross Procedure Surgeon in the NE is Dr. Paul Stelzer, Beth Israel Med. Ctr., NYC.

He is now at Mt. Sinai in NYC. He seems to be very accessible, will call people individually to get a sense of their situation, etc. I'm not going Ross but had a very good phone chat with him when I was considering it. Called the office to find out their process for scheduling consults and was surprised to get a personal call back from him shortly after that.

 

[netmiff]

. . . and not psyched about the idea of coumadin for the rest of his life.

Unless he has a high-risk job or hobbies that he is not willing to give up, warfarin is not a big deal. I have been on it for almost a whole yer now, have had a few blips, but the folks on here know more than most medical people and have given me the confidence to be much more pro-active in my INR management. Take a look around the anti-coagulation forums, especially the stickies, check out member Al Lodwick's web site ( addess wil be somewhere); he is a pharmacist who is a certified anti-coag specialist, has written much, and now goes around USA teaching to medical professionals.

As far as I was concerned, it was a no-brainer - and this is a very personal choice/decision that has to be made. at 52 years old, not particulary active, but not a couch potato either, I chose mechanical because I really do not want another OHS, although now that I have had one, I would not be nearly so nervous next time! However, my surgeon says that the first time round, the patients are nervous wrecks, and the second time round, it is the surgeons that are nervous

Ask any specific questions you have, I am sure you will get answers.

 

[ALCapshaw2]

Just found out that our surgeon has only done 13 Ross precedures so we're rethinking this option and looking into mechanical and tissue vavles. Both of us feeling overwhelmed.

Haven't heard from you since this post 5 days ago.

You keep saying "our surgeon" as if this is the ONLY guy you have / will consider. Is that the case?

FYI, unless you are in an HMO, you can make "Self Referals".

Just call the office of surgeons you are interested in, tell them your condition and why you want to interview that surgeon. Most will accept appointments with prospective Heart Surgery Patients. They will want copies of your latest Echocardiogram Report AND Tape(s) and any other test results you have. You can get copies of your test reports (and tapes) from the facility that performed the tests by signing a simple 'Release Form'.

You may also want to read the "Stickys" at the top of the Anti-Coagulation Forum to get a better / realistic view of what it is like living with / on Coumadin / Warfarin. There are a lot of Horror Stories from 'the days of Olde' before testing and monitoring procedures were improved (in the early 1990's). Most of us find it to be NO BIG DEAL in our daily lives. Invasive procedures (especially other surgeries) require 'special procedures' (i.e. Bridging) but even that is not too bad if done properly.

From the tone of your posts, it sounds to me like you need More Information and More Opinions before making a decision. FWIW, I found that I learned something new from every Surgeon I interviewed. There are several EXCELLENT Heart Surgeons in Boston at Brigham and Women's Hospital and at Mass. General Hospital. If you are still interested in the Ross Procedure, you can't beat Dr. Stelzer in NYC. "Let your fingers do the walking"

 

[Pete]

Just found out that our surgeon has only done 13 Ross precedures so we're rethinking this option and looking into mechanical and tissue vavles. Both of us feeling overwhelmed.

Sounds like youre throwing the towel in on the Ross Procedure. Why?? Get a 2nd, or even a 3rd opinion if you have to. Bring your images/reports and hop on the Amtrak to see Stelzer at Mount Sianai. He spent 2 casual hours with me and my family going over my CTA. Best of luck to you.

 

[dcpickle]

It is often said that for the Ross Procedure you want someone with lots of experience. That's true, and I'm pretty sure Dr. Stelzer has done more Ross's than anyone else other than Mr. Donald Ross in the UK, who is retired, and maybe Dr. Ronald Elkins, who is also retired. Dr. Stelzer worked to develop a surgical technique where the entire aortic root is replaced. This technique has now become standard, and I understand it has greatly improved the success rate of the Ross Procedure. If you're still considering the Ross, you should talk to Dr. Stelzer. He's very down-to-earth and will talk to you as if you're his best buddy. (BTW, you don't necessarily have to visit him in person. You can send your info. via mail or email, and he can call you. Just be prepared to spend an hour or more on the phone!)

Good luck with whatever you choose. There IS life on the other side!

 

[UniBmx]

New here.
As Leroy996 said, I have had the Ross Procedure
and life couldn't be better.
Still ride bikes allot and bmx with my son Noah.
Just saying hi

Bernard

 

[Ross]

New here.
As Leroy996 said, I have had the Ross Procedure
and life couldn't be better.
Still ride bikes allot and bmx with my son Noah.
Just saying hi

Bernard

Welcome to the insane asylum! If your a little left of center and perhaps upside down, you'll fit right in.

 

[Ambience]

A few things I was told about Ross that made me select an artificial valve as I was on the table getting shaved.

Once your second valve is removed to swap to Aorta, the valve becomes like any other previously removed valve, meaning that it has the same risk of decay as a tissue valve. Re-op was my biggest fear going into this whole process, and I know having an artificial valve is no guarantee that I'll never find myself on the operating table again, but having two valves in my heart that will risk needing replacement as opposed to just a single valve weighed heavily into my decision for an artificial one.

I've adapted to coumadin, and I've been told that a different type of anti-coagulant is in its final testing phases by the FDA that will prevent the monthly blood tests.

I wish I had known this information before going straight to op, so I thought I'd share a bit.

 

[mikeb85]

I am 49 and chose the tissue valve because I personally wanted no part of coumidin. I ended up having to take it(Coumidin) for about a month because of a couple of A-Fib episodes and am almost through with it now. The hardest part of the whole thing was the "NO PROMISES" part. If I chose mechanical there was no garranty that another surgery would not be needed and same deal with the tissue valve, no garranty that you wont need to be on Coumidin for A-Fib. In the end I found that the surgery was not that hard to go thru and I will deal with possible re-ops when the time comes. Bottom line is that it is YOUR personal choice, Do the research,make your choice and move forward!

Good Luck!
Mike

 

[lilpep25]

A few things I was told about Ross that made me select an artificial valve as I was on the table getting shaved.

Once your second valve is removed to swap to Aorta, the valve becomes like any other previously removed valve, meaning that it has the same risk of decay as a tissue valve. Re-op was my biggest fear going into this whole process, and I know having an artificial valve is no guarantee that I'll never find myself on the operating table again, but having two valves in my heart that will risk needing replacement as opposed to just a single valve weighed heavily into my decision for an artificial one.

I've adapted to coumadin, and I've been told that a different type of anti-coagulant is in its final testing phases by the FDA that will prevent the monthly blood tests.

I wish I had known this information before going straight to op, so I thought I'd share a bit.

I just wanted to second that. I did have the Ross procedure, Dr. W. Ryan in Dallas felt it was the best thing for me, and being 25 and naive at the time, I went with it. Having a tissue valve just for the aorta was never an option with him as my doctor. I guess if I had chosen that, I still would have had issues though. My tissue valve began severely failing in 2005 when I was pregnant, and it was at the point where I had to have surgery or I would not be here much longer in 2007.

I do believe what bothered me the most, was when Dr. Denton Cooley came into my room at St. Lukes to talk to me (I had been his patient in 1978, and he visits all past patients who come there). When Dr Cooley tells me that the Ross procedure is a poor choice, he means it. He will never recommend it because it will give you 2 valve issues. I truly wish I had known that in 2002 when I had the Ross procedure done. It might have made me get another opinion, because I later learned that other cardiologists felt I did not need any surgery at that time. I guess when you are 25 and fairly healthy you seem like a great candidate to test things out on... I was #101 for Dr. Ryan. I will never return to Dallas for any medical procedures, not just because of that, but because Presby hospital sent me home with an infection that the surgeons pretty much blew off until I was in the ER close to death, so I had lung surgery 2 weeks after OPS.

I know what valve failure feels like now, and I had never been close to that until 2 yrs ago.

I will recommend that anyone getting a valve replacement get 2 or more opinions. Don't let fear drive you to make the wrong choice.

 

[rckrzy1]

I just wanted to second that. I did have the Ross procedure, Dr. W. Ryan in Dallas felt it was the best thing for me, and being 25 and naive at the time, I went with it. Having a tissue valve just for the aorta was never an option with him as my doctor. I guess if I had chosen that, I still would have had issues though. My tissue valve began severely failing in 2005 when I was pregnant, and it was at the point where I had to have surgery or I would not be here much longer in 2007.

I do believe what bothered me the most, was when Dr. Denton Cooley came into my room at St. Lukes to talk to me (I had been his patient in 1978, and he visits all past patients who come there). When Dr Cooley tells me that the Ross procedure is a poor choice, he means it. He will never recommend it because it will give you 2 valve issues. I truly wish I had known that in 2002 when I had the Ross procedure done. It might have made me get another opinion, because I later learned that other cardiologists felt I did not need any surgery at that time. I guess when you are 25 and fairly healthy you seem like a great candidate to test things out on... I was #101 for Dr. Ryan. I will never return to Dallas for any medical procedures, not just because of that, but because Presby hospital sent me home with an infection that the surgeons pretty much blew off until I was in the ER close to death, so I had lung surgery 2 weeks after OPS.

I know what valve failure feels like now, and I had never been close to that until 2 yrs ago.

I will recommend that anyone getting a valve replacement get 2 or more opinions. Don't let fear drive you to make the wrong choice.

This is the first negative report I have ever heard concerning Dr. Ryan. He is now just over 200.